Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT04702724 |
| Other study ID # |
STU00213443-B |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
May 10, 2021 |
| Est. completion date |
June 30, 2022 |
Study information
| Verified date |
October 2022 |
| Source |
Northwestern University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
Memory benefits from sleep and these benefits are putatively achieved through reactivation of
the neural memory trace during sleep. Studies examining the effects of reactivation commonly
focus on single, isolated items - but real-life memories never exist in a vacuum. Individual
memories are bound to the context (e.g., the location, time and state of mind in which they
are encoded) and this context is later reinstated to recall the details related to the
memory. The question of how context participated in the process of sleep reactivation has
never been directly examined. This experiment will monitor brain activity during memory
encoding, sleep and finally retrieval to investigate the role context plays in sleep-related
memory consolidation. Monitoring will be done using functional magnetic resonance imaging
(fMRI) and electroencephalographic (EEG) recordings. Participants will go through a series of
training trials, in which they will have to learn to associate several small images of items
or animals with a larger image of scenes - and also learn the spatial location of these
smaller images on the screen. The order of the presented images and the scenes in which they
are embedded will remain constant throughout training, creating a solid, consistent temporal
context in which item memories will be embedded. After training, participants will receive a
90 minute nap opportunity, during which the sounds associated with specific images will be
unobtrusively presented. I expect memory for the spatial location of the cued images to
improve. Importantly, I hypothesize that this effect will carry over to other items
associated with the same scene (i.e., embedded in the same context) and that the temporal
order in which the images were learned will govern this effect. I will use the EEG and fMRI
data to estimate, on the basis of neuronal pattern activity, the level of contextual
reinstatement and will build on these data, in combination with the behavioral results, to
model the level of contextual involvement during sleep. These results could pave the way
towards a unified theory of sleep's role in memory consolidation, which would encompass
computational models of context and memory as well.
Description:
Each participant will be run in a single afternoon, which includes a 90-minute nap
opportunity. This study will be divided into three continuous sessions. The first and third
sessions will be done inside the MRI scanner, whereas the middle session will be conducted
outside of the scanner, while recording electrophysiological data. The crucial manipulation
involves the careful control of temporal context, which is accomplished by preserving the
temporal order of trials during training and using spatial scenes as markers of context.
This is a within-subjects study. The main manipulation is the unobtrusive presentation of
sounds during sleep, a technique called targeted memory reactivation (TMR). All participants
will hear these sounds, but the specific sounds each one will hear will be different. The
results will then be compared within participant, not between different groups or
individuals. Appropriate statistical methods for such analyses include paired t-test and
repeated measures analysis of variance. The choice of which sounds will be presented to each
participant will be made based on their performance in the pre-sleep test. This will be done
in an attempt to balance pre-sleep scores between presented and unpresented stimuli to remove
statistical noise. Both the participant and the experimenter will be blind to which sounds
will be presented, and the selection will be automatically made by the computer. This
technique has been extensively used and has no known risks.
There are two main reasons that using a within-subject design reduces the required sample
size. First, the lack of a between-subject independent variable intuitively requires less
participants. Second, the level of statistical noise due to individual differences is reduced
(i.e., because each participant is compared with their own scores). Previous TMR studies,
which have found significant cuing effects, commonly used 20-25 participants. I plan to
include at least 30 participants in this study, after omitting participants who could not
complete the task and those who were not sufficiently cued during sleep. Having 30
participants will allow the use of more powerful statistical methods (in accordance with the
common rule of thumb derived from the central limit theorem, which states that means based on
sample sizes of more than 30 participants can be assumed to follow a normal distribution). I
expect the context-related TMR effect (see summary) to be smaller in magnitude relative to
the common effect size observed in spatial learning TMR studies (Hedge's g = 0.39 based on a
recent meta-analysis15). This is why I included a higher sample size. It is important to note
that even if this benefit will be of a smaller magnitude, as I expect, it will still be
indicative of the underlying neurocognitive process and therefore extremely valuable for our
mechanistic understanding of the role of context in sleep. Aiming at a sample size of at
least 30 participants and assuming an omission rate of 80%, I therefore plan to have 38
participants altogether.
Here is a brief summary of the procedure:
Stimuli: 12 images of spatial scenes (e.g., a beach) will each be arbitrarily associated with
five smaller images of objects or animals. As described later, half of the scenes will be
associated with a right hand motion and half with the left - and half of each of these groups
will be cued during sleep. Each of the 60 images will each have a unique 2D position on a
circular grid presented on the screen and will be accompanied by a specific, congruent sound
(e.g., cat - meow).
fMRI Localizer: After the participant is first put in the scanner and a basic anatomical scan
is complete, they will be exposed to all the different scenes while being scanned. This will
later be used to classify scene-specific blood-oxygen-level-dependent (BOLD) responses.
Training: First, participants will learn to associate scenes with a hand motion. They will
repeatedly see each scene on either the left or right side of the screen and be asked to
imagine touching the image on the projected screen. In this and every following training
block, the scenes will be presented in a participant-specific, non-randomized order. Next,
participant will be exposed to all 60 images' locations on the grid and asked to associate
the image with the scene and remember the location. The images for each scene will
consistently be presented in the same order within the scene, and therefore the order of the
60 images will be maintained throughout training. The left/right sides of the screen will be
used for each scene in accordance with its designated hand in the previous training stage.
After two rounds of exposure, participants will go through a similar positioning phase of
training. They will be shown the image and the scene and asked to associate them. Then, they
will see the circular grid without the image on it and asked to imagine touching the correct
location with the appropriate hand. The next screen will show the image in its correct
location and ask participants to signal whether or not they knew the location. The next image
will be presented after a short inter-trial interval. An image's location is considered
learned when it was marked as correct twice in a row. Blocks will be repeated in the same
order until all locations are learned. For the images which were already learned, the
repeated block will employ an alternative task to avoid over-learning while maintaining the
temporal order of items.
Pre-sleep test (in scanner): After training, participants will be presented with all images
in a pseudo-random order and asked to imagine touching their correct location on the grid
with the appropriate hand.
Pre-sleep test (EEG): Outside the scanner, the participant will be fitted with an EEG cap and
then asked to take another test. Here, images will again be randomized and participants will
first be asked to imagine touching the correct location and then ordered to actually touch
the correct position. Subsequent measures of change in spatial memory will be based on the
performance in this test. Throughout the task, the act of imagining the hand motion is not
used to decode the exact position on the screen in which the participant thinks the item
should be located. Instead, imagined hand motion will serve as a rough measure of hemisphere
specific reactivation, that will then be used to classify reactivation during sleep in the
EEG, as done in 64. Although this decoding will primarily be done using EEG and not fMRI, the
instructions to imagine hand motion are the same for all phases of the experiment in order to
maintain consistency throughout the task.
Sleep: During NREM (non-rapid eye movement) sleep, the sounds associated with specific images
will be presented unobtrusively. The scenes from which these images will be chosen will be
half of the right- and half of the left-handed ones. For each of these scenes, one image will
be cued, positioned in either the 2nd, 3rd or 4th place in that set's training sequence. The
choice of which sounds to present will be made in a manner that will balance pre-sleep
results and therefore enhance the contrast between sleep-related effects for cued and
non-cued images.
Post-sleep test (EEG): At least 10 minutes after the end of the nap, participants will start
this test, which will be identical to the Pre-sleep test (EEG).
Post-sleep test (in scanner): Identical to the Post-sleep test (in scanner). Scene-image
association test: Finally, participants will be shown each image in a randomized order and
asked to indicate which of four presented scenes is associated with it.
fMRI Localizer: Same as the first. Participants will finally be thanked, debriefed, paid and
dismissed.
